[Kawasaki disease complicated with hemorrhagic enteritis mimicking intestinal obstruction: report of one case].
A 6-month-old little boy presented with fever and cervical lymphadenopathy for four days. On admission, he was found to have conjunctival congestion of both eyes, reddened and fissured lips, straw-berry tongue, macular rash at the trunk and erythematous change on the BCG injection site. The diagnosis of Kawasaki disease was made and aspirin therapy (100 mg/kg/day) was started. On the 3rd hospital day, he developed abdominal distention, jaundice, poor activity and tachypnea. Bowel sound was silent on auscultation. Nasogastric tube was inserted for decompression and bilious material was drained out continuously. In addition, bloody, mucoid stool passage was noted. An abdominal radiography revealed dilatation of the small bowel and paucity of the colon gases. On the abdominal ultrasound, hydrops of gallbladder, marked ascites and silent and dilated bowel loops were found. Despite of supportive care, abdominal symptoms persisted and condition deteriorated. Laparotomy was done on the following day. At operation, it was found that the patient developed severe petechia on the long segment of small intestine from 15cm distal to the Treitz ligament to ileocecal valve and some fibrin plagues on the terminal ileum at 25cm proximal to the ileocecal valve were also found.
Huang
Y C
YC
Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan, R.O.C.
Ho
M Y
MY
Huang
F Y
FY
Hsu
J C
JC
D004751:Enteritis / Q000209:etiology*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D007223:Infant; D007415:Intestinal Obstruction / Q000209:etiology*; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications*